Is Viagra Covered By Insurance?

Is Viagra Covered By Insurance

If you want to try Viagra for erectile dysfunction (ED), you might be surprised at what a big hole it can burn in your pocket. Given that ED is a medical condition with far-reaching implications for your health and quality of life, you might think that Viagra (and other erectile dysfunction medications that work in a similar way) would be covered by insurance. Unfortunately, this is not always the case.

General information

  • Many insurance plans do not cover Viagra (or Cialis, Levitra or Stendra – other branded drugs in the same class as Viagra). However, some plans cover generic versions of these drugs.
  • Generics include sildenafil citrate, tadalafil, and vardenafil, and may be slightly cheaper than brand-name versions if not covered by your insurance plan.
  • Some insurance companies may also cover some doses but not others.
  • You will need to contact your specific plan provider to find out what prescription drugs and dosages are covered, and if there are any other restrictions.

The good news is that even if your insurance company doesn’t cover Viagra, there are more affordable options.

Will my insurance cover Viagra?

As with any drug, treatment, or diagnostic test, each health plan has different rules about what they will and will not cover. Many insurance companies have a list of the drugs they will cover under various plans on their websites.

For example, some large companies under Blue Cross Blue Shield cover some of the cost of Viagra, as well as other phosphodiesterase-5 (PDE5) inhibitors (which include the Viagra class drug) such as Cialis and Levitra. Cigna also cover these drugs under some of their plans.

No matter what insurance plan you have, it’s important to call your insurance company to find out what drugs they cover and under what circumstances. They may have certain pre-approval requirements (where someone from the insurance company will have to check your healthcare provider’s prescription before allowing coverage). Or they may limit the amount you can get at a time and the number of refills available. You will also need to inquire about any co-payments.

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Viagra is not the only drug to treat erectile dysfunction. When you call your insurance company to check the information, be sure to also ask about coverage for any of the following drugs (unless Viagra is covered):

  • Sildenafil citrate (this is the active ingredient in Viagra)
  • Cialis (or its analogue tadalafil)
  • Levitra (vardenafil)
  • Stendra (avanafil)

If your insurance company covers some drugs but not others, talk to your doctor to see if switching to covered drugs makes sense for you. Your insurance provider may also offer different coverage for different doses and uses. For example, Cialis is available in two ways: as needed (2.5mg, 5mg, 10mg or 20mg) or daily (2.5mg and 5mg) (Brock, 2016). Your insurance may cover one but not the other.

If your insurance covers any of these drugs, you may still need to pay a copay, or your coverage may not start until your deductible is fulfilled. Each plan is individual.

How much does Viagra cost? Out-of-pocket expenses

If your insurance plan does not cover Viagra, the out-of-pocket drug costs can be quite high. 30 100mg tablets can cost up to $2,000. However, each pharmacy offers its own prices, so you should take a closer look at them. By the way, do you know how old do you have to be to buy Viagra? No-one under the age of 18 can buy it as the FDA has not approved the use of sildenafil for treating ED in children and teenagers.

The price of Cialis varies widely depending on the dosage. The lowest dose (2.5mg) typically costs around $350 for 30 tablets, while the highest dose (20mg) can cost over $2,000.

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The average retail price for Levitra is around $1,700 in all dosages per 30 tablets.

Finally, Stendra, which is less commonly prescribed medication for ED, costs about $1,600 out of pocket.

However, don’t be discouraged by such high prices! There are more affordable ED treatment options.

Cheaper alternatives to Brand Viagra, Cialis and Levitra

Many online pharmacies offer cheaper versions of the three well-known PDE5 inhibitors on the market.

Cheaper Alternatives to Viagra

There are many cheaper versions of brand-name Viagra. These are drugs that contain the same active ingredient – sildenafil citrate: generic Viagra, Cenforce, Silagra, Eriacta, Zenegra, Suhagra, Intagra, Vigora, Assurance, Silvitra, and generic Revatio.

Generic Viagra is similar to Viagra and comes in the same doses.

Revatio is an FDA-approved drug for the treatment of a specific type of high blood pressure in the lungs .

It may seem strange, but Revatio has the same active ingredient as Viagra. The difference is that this medicine has different strengths. Viagra is available in tablets of 25, 50 and 100 mg, Revatio – in tablets of 20 mg. Some healthcare professionals prescribe generic Revatio in doses of 20, 40, 60, 80, or 100 mg to treat ED. However, this is considered an off-label use as Revatio and its generic form are not approved by the FDA for the treatment of ED.

Generic Revatio is a much more affordable alternative to Viagra. 30 20mg Revation pills are available for as little as $2.40 per pill at Pharmacy Mall .

Cheaper Alternatives to Cialis

The active ingredient in Cialis is tadalafil, which is a longer acting drug than sildenafil citrate (meaning it lasts longer in the body), but is about equally effective.

Cheaper generic verions of brand-name Cialis are Magalis, Tadacip, Cialis Soft, Tadora, etc.

You can get Generic Cialis for about $54 for 30 doses (with some minimal variation with different doses) at Pharmacy Mall. Of course, it depends on which pharmacy you use.

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Cheaper Alternatives to Levitra

Levitra is the brand name for vardenafil, another PDE5 inhibitor that treats ED in a similar manner to sildenafil citrate and tadalafil.

Generic Vardenafil is much cheaper than the branded Levitra – it will cost about $53 for an average of 30 doses.

Is Viagra covered by Medicare or Medicaid?

If you are in a Medicare or Medicaid plan, you will need to look at your plan’s benefits to find out about prescription drug coverage. In general, one of the generic versions – sildenafil citrate, tadalafil, or vardenafil – is more likely to be covered by your Medicaid or Medicare plan than their brand-name counterparts. Medicare Part D plans are for prescription drug coverage.

How do PDE5 inhibitors treat erectile dysfunction?

Viagra, Cialis, Levitra and their analogues are examples of PDE5 inhibitors, drugs that treat sexual dysfunction in men. PDE5 inhibitors block the PDE5 enzyme. This enzyme, if not blocked, breaks down cyclic guanosine monophosphate (cGMP), which is a chemical that causes penile blood vessels to relax. When PDE5 is blocked (by PDE5 inhibitors), cGMP levels rise, causing better blood flow to the penis. Improved blood flow to the penis promotes stronger erections.

Make the right choice based on your budget

All of these drugs work in a similar way, with some differences in how long they last in the body and in side effects. Ultimately, the choice of medication will depend on the doctor’s advice, as well as what fits best within your budget. Call your insurance company to find out if any of these drugs are covered by your plan. If they are not covered, look for the most affordable options offered by various licensed pharmacies like Pharmacy Mall.